Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate

Arthroscopy. 2010 Oct;26(10):1318-25. doi: 10.1016/j.arthro.2010.02.010. Epub 2010 Aug 30.

Abstract

Purpose: To evaluate integration and maturation of semitendinosus-gracilis (STG) grafts in anterior cruciate ligament (ACL) reconstruction with magnetic resonance imaging (MRI) in patients who underwent ACL reconstruction with STG with and without autologous platelet concentrate (APC).

Methods: A randomized single-blinded evaluator prospective study was performed in 2 consecutive series of patients who underwent reconstruction over a 14-month period: 30 with APC use (group A) and 20 as control subjects (group B). At 6 months, an MRI evaluation was performed, with observation of the graft's maturation and presence or absence of synovial fluid at the tunnel-graft interface. To facilitate interpretation, a scoring scale was designed to evaluate graft integration and maturation.

Results: Regarding the presence of synovial fluid at the bone-graft interface, the test was negative in 86.84% of patients in group A and 94.74% in group B. A disorganized autograft signal pattern was found in 2.63% in group A and 5.26% in group B. Signal intensity was considered hypointense in 63.16% in group A and 42.11% in group B, isointense in 34.21% in group A and 52.63% in group B, and hyperintense in 0% in both groups. The final mean score was 4.45 points in group A and 4.2 points in group B (P ≥ .05). Poor integration was found in 2.63% in group A and 5.26% in group B (P = .214). Good integration was found in 97.37% in group A and 94.74% in group B (P = .784).

Conclusions: In our consecutive series of patients who underwent ACL reconstruction with STG grafts, 1 group with intraoperative APC use versus a control group, followed up by MRI at 6 months after reconstruction, we did not find any statistically significant benefit in the APC group in terms of integration assessment and graft maturation (ligamentization).

Level of evidence: Level III, case-control study.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anterior Cruciate Ligament / surgery*
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Patellar Ligament / pathology
  • Patellar Ligament / surgery
  • Patellar Ligament / transplantation
  • Platelet Transfusion
  • Postoperative Period
  • Reconstructive Surgical Procedures / methods*
  • Reconstructive Surgical Procedures / rehabilitation
  • Single-Blind Method
  • Transplantation, Autologous / methods